Publish and Perish ?
Authors: DARRELL D. FANESTIL
Journal: Journal of the American Society of Nephrology (1999)

Medical libraries are experiencing a funding crunch. Although this is not specific to medical libraries (1), funding of libraries is an issue that spans the continent (2,3). At the University of California San Diego (UCSD), the Medical Libraries proposed subscription to 1250 titles in 1997/1998. This represented a 48% decrease since 1991/1992! Faculty pleas resulted in a last minute "temporary funding bail-out," which decreased cancellations from about 400 to 189 titles. Cancellations in renalrelated fields included Clinical & Experimental Hypertension, Kidney and Blood Pressure Research, Nephrologie, Urologia Internationales, and Urological Research. In this editorial, I address three issues relating to libraries: the causes of the fiscal crunch, short-term measures, and long-term solutions. Causes of the Library Funding Crisis Superficially, one might respond that the cause of the funding problem is that the cost of journals has escalated faster than inflation. Indeed, at UCSD libraries (medical, science, and non-science) the average annual price per journal (n = 2479) increased from $272 in 1990 to $584 in 1997 (4), an annual rate of increase of 11.5%. This far exceeds the concurrent average annual inflation rate of 3.0%. This library crisis is multifactorial in scope (5). It is easy to blame profit-hungry publishers for this problem. Admittedly, publishing companies are not blameless. Commercial publishers have been especially active in creating new journals to fill new or perceived niches. Instead of following the less expensive practice of expanding the size of volumes and gradually increasing the price, some publishers determined that five issues constitute a volume, then combined issues so that each volume might be only two or three "combined issues." Indeed, the cost per page of journals does vary considerably. The institutional cost per page of 24 selected journals (see Table 1) ranges from $0.04 to $1.20. The distribution is skewed, with eight journals more than 40 cents per page. Admittedly, these journals center on subspecialty and specific areas of research related to my own interests. It did come as a surprise to me that the per page cost of journals can vary 30-fold!Table 1: Library cost of selected journalsaPlacing the blame for escalating journal costs solely on publishing companies, however, assumes that the number of pages per journal is constant. This assumption is not supported by the history of nephrology. Figure 1 shows that the number of pages published per year in Kidney International increased 4.9-fold from its inception in 1972 through 1997. The cost of this journal, if adjusted both for increased numbers of pages and inflation, would have had to increase 20.8-fold over those 26 years—a compound annual rate of increase of 12.24%! When one considers additional new nephrology journals initiated over this time span—including such growing journals as American Journal of Kidney Diseases, Journal of the American Society of Nephrology, and The American Journal of Nephrology—the number of pages in journals basic to nephrology must have escalated well over 10-fold (for example, in 1997 JASN and KI published 7.4-fold more pages than KI in 1972), and I estimate that the inflation-adjusted cost to publish these several journals must have escalated over 100-fold during this time span!Figure 1.: Number of pages published per year in Kidney International, 1972-1997.An important concern, then, is why there has been such a big increase in published pages. In nephrology, we can point to the emergence of an important new subspecialty and to the rapid and enormous advances that needed to be communicated. Is there something else? Does every new development need to be reviewed in almost every journal? For example, Medline lists 20 reviews with the title word "aquaporin" since 1992; aquaporins were first described in 1991. Perhaps more pervasive is that in academia we currently must publish for advancement. Does this practice flood the literature, thereby escalating library expenses unnecessarily? The cause of the large increase in cost of journals we want in our libraries is multifactorial, including inflation, more authors, more knowledge to transmit, more manuscripts submitted and published, more journals, more profit. Short-Term Measures to Alleviate the Problem A common solution suggested to alleviate the problem of escalating costs of journals is electronic publishing. However, electronic publishing will not likely be "the" solution. True, many journals are now available via the Internet, sometimes (at present) without payment above that required to access the Internet. But librarians are protesting that E-Journal pricing by publishers is excessive (6,7). Publishers are additionally placing unprecedented new restrictions on distribution and use of electronic journals (5). Several questions arise. Is electronic publishing substantially cheaper? Electronic publication only saves the printing and mailing costs of journal production. Editorial office expenses and personnel, time of the editor(s), telephonic and mail communication, and redacting are not decreased by electronic publication. Thus, subspecialty journals with relatively low subscribership may not be substantially less costly to produce in electronic format than in print versions. One estimate is that "first copy" costs are 70 to 80% of the total cost for many and perhaps most academic (not necessarily medical) journals—these costs do not disappear with electronic publication (4). Additionally, will advertising revenue in electronic journals change? If there is a decrease in advertising revenue, the savings via electronic publication may be offset. Who will archive (both preserve and make accessible) the material (8)? What if the publishing company goes out of business or merges with another company that decides to discontinue the journal? If your local library has not archived the article you want, where will you find it? More importantly, at what cost? The prospects of "pay per use" cannot be dismissed lightly (4,5). My best guess at this time is that these legal and logistical problems will be resolved, but that the cost savings in electronic publication will offset the increasing cost of transmitting more and more information for only a few years, at the most. Another suggestion for cost saving is that libraries must collaborate so that journals are available to be shared (electronically, if not prohibited by publishers), even though not present in your local library. This will be another way in which some savings can accrue. I do not have a good estimate about the impact perfect implementation of inter-library sharing would have on alleviating the current problem. At present, each library is being driven by cost constraints to a near-identical irreducible core of journals that the faculty of every medical school demands of its library. What is that core of journals? I submit that a first approximation is that the core journals are those in which faculty publish. Thus, I encourage you to look at the subscription cost (per page) of those journals in which you publish your papers. A second approximation of core journals is those journals you want immediately available when you walk into your library. Additionally, consider where you volunteer your time as a reviewer of manuscripts. Is there a point where one should stop participating as author, as reader, or as gratis reviewer? If so, what is that cost? Is it $1.20 per page, $0.50 per page, $0.25 per page? There is no reason to believe that publishing companies are immune to the marketplace. If we stop participating, they will either lower journal prices or leave the field open for more competitive publishers. Longer-Term Solutions A number of ideas are being advanced. Our scholarly communication system is under discussion. In part, publication is driven by the need to publish for academic review and advancement. We "publish or perish." The ever-increasing cost of publishing threatens to turn this into "publish and perish" (9)! The American Association of Universities has advanced a proposal to decouple the publication of scholarly works from peer review. In this plan, peer review to evaluate the quality of research will be certified by "professional societies and other bodies," rather than publishing companies (10). I find it difficult to disagree with the idea that more attention to quality and uniqueness of publication is needed, with less attention to numbers of publications. Would research be sliced into the smallest publishable unit and presented in a series of papers with repetitive introductions and redundant discussions, and would review after review be published if we were permitted to submit a maximum of five (or so) publications rather than a multi-page bibliography for our academic advancement? Importantly, the very nature of the ownership of publication is being discussed. Copyright ownership of creative materials and products is guaranteed by the Constitution (Article I, Section 8): "The Congress shall have power to lay and collect taxes, duties, imports and excises….; to promote the progress of science and useful arts, by securing for limited times to authors and inventors the exclusive right to their respective writings and discoveries;…" Why do we sign away our ownership when we submit material to a journal? Think of it. Research conducted (for the most part) with voluntarily contributed or public money, conceived by our ideas, generated by our work, summarized for publication by our efforts, and critically reviewed without charge by knowledgeable colleagues is donated to publishers! And to what end? So that the publisher can sell it back to us and our libraries, often at profit-generating rate; so that we have to ask permission to use our own figures in a teaching handout. Will authors demand retention of ownership of their creative efforts? Should our universities and learned societies publish our work without demanding ownership? This is not fanciful speculation. The University of California has convened a task force to consider the current legal environment regarding publication in the digital age. Models under consideration "may well require new publication initiatives on the part of the University. These could be initiatives to publish scholarly electronic journals by the University… or they could be initiatives to establish Web-based publishing such as the preprint server managed by Los Alamos National Laboratories for the physics community (5)." Conclusion Escalating costs of publishing and purchasing ever-increasing quantities of written materials are imperiling our traditional methods of scholarly communication and the fiscal viability of our libraries. The answer will not come if all we do is shout: "More money!" We who submit our creative work for publication need to assess how we do so and where we do so. The coming change in scholarly communication will occur with or without the participation of the nephrology community. I believe that we will all benefit if the nephrology community participates in molding that future.